Kaposi's sarcoma differential diagnosis: Difference between revisions

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Kaposi's sarcoma must be differentiated from other diseases that cause similar [[cutaneous]], [[pulmonary]], and [[gastrointestinal]] involvement, such as [[bacillary angiomatosis]], [[AIDS]]-related [[lymphoma]], and [[seborrheic keratosis]].<ref name="radio">Kaposi's Sarcoma. Radiopaedia (2015) http://radiopaedia.org/articles/kaposi-sarcoma Accessed on January, 19 2016</ref><ref name="patho">Libre Pathology. Kaposi's sarcoma (2015) http://librepathology.org/wiki/index.php/File:Kaposi_sarcoma_low_intermed_mag.jpg Accessed on January, 19 2016</ref><ref name="patho2">Kaposi's Sarcoma. PathologyOutlines (2015) http://www.pathologyoutlines.com/topic/skintumornonmelanocytickaposisarcoma.html Accessed on January, 19 2015</ref>
Kaposi's sarcoma must be differentiated from other diseases that cause similar [[cutaneous]], [[pulmonary]], and [[gastrointestinal]] involvement, such as [[bacillary angiomatosis]], [[AIDS]]-related [[lymphoma]], and [[seborrheic keratosis]].<ref name="radio">Kaposi's Sarcoma. Radiopaedia (2015) http://radiopaedia.org/articles/kaposi-sarcoma Accessed on January, 19 2016</ref><ref name="patho">Libre Pathology. Kaposi's sarcoma (2015) http://librepathology.org/wiki/index.php/File:Kaposi_sarcoma_low_intermed_mag.jpg Accessed on January, 19 2016</ref><ref name="patho2">Kaposi's Sarcoma. PathologyOutlines (2015) http://www.pathologyoutlines.com/topic/skintumornonmelanocytickaposisarcoma.html Accessed on January, 19 2015</ref>
==Differentiating Kaposi's Sarcoma from other Diseases==
==Differentiating Kaposi's Sarcoma from other Diseases==
*Kaposi's sarcoma must be differentiated from other diseases that cause similar [[cutaneous]], [[pulmonary]], and [[gastrointestinal]] involvement, such as:<ref name="radio">Kaposi's Sarcoma. Radiopaedia (2015) http://radiopaedia.org/articles/kaposi-sarcoma Accessed on January, 19 2016</ref><ref name="patho">Libre Pathology. Kaposi's sarcoma (2015) http://librepathology.org/wiki/index.php/File:Kaposi_sarcoma_low_intermed_mag.jpg Accessed on January, 19 2016</ref><ref name="patho2">Kaposi's Sarcoma. PathologyOutlines (2015) http://www.pathologyoutlines.com/topic/skintumornonmelanocytickaposisarcoma.html Accessed on January, 19 2015</ref>
*Kaposi's sarcoma must be differentiated from other diseases that cause similar [[cutaneous]], [[pulmonary]], and [[gastrointestinal]] involvement.<ref name="radio">Kaposi's Sarcoma. Radiopaedia (2015) http://radiopaedia.org/articles/kaposi-sarcoma Accessed on January, 19 2016</ref><ref name="patho">Libre Pathology. Kaposi's sarcoma (2015) http://librepathology.org/wiki/index.php/File:Kaposi_sarcoma_low_intermed_mag.jpg Accessed on January, 19 2016</ref><ref name="patho2">Kaposi's Sarcoma. PathologyOutlines (2015) http://www.pathologyoutlines.com/topic/skintumornonmelanocytickaposisarcoma.html Accessed on January, 19 2015</ref>
:* '''Kaposi's sarcoma cutaneous lesions must be differentiated from:'''
::*  
::* [[Bacillary angiomatosis]]
::* [[Arteriovenous malformation]]
::* Acroangiodermatitis
::* Masson's [[hemangioma]]
::* [[Angiosarcoma]]
::* [[Seborrheic keratosis]]
::* Erythematous [[SLE|lupus]]
::* Pigmented purpuric dermatosis
::* [[Pyogenic]] [[granuloma]]
::* Benign lymphangioendothelioma
::* Cavernous [[hemangioma]]
::* Sarcomatoid carcinoma
::* [[Spindle cell]] hemangioendothelioma
 
:* '''Kaposi's sarcoma pulmonary lesions must be differentiated from:'''
::* [[AIDS]]-related [[lymphoma]]
::* [[Atypical pneumonia]]
::* [[Fungus|Fungal]] or [[mycobacteria|mycobacterial]] infection
::* [[Lung cancer]]
 
:* '''Kaposi's sarcoma  gastrointestinal lesions must be differentiated from:'''
::* [[Peptic ulcer disease]]
::* [[Inflammatory bowel disease]] (IBD)
::* [[Gastrointestinal tract cancer]]


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Revision as of 14:41, 1 October 2018


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farima Kahe M.D. [2] Haytham Allaham, M.D. [3]

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Overview

Kaposi's sarcoma must be differentiated from other diseases that cause similar cutaneous, pulmonary, and gastrointestinal involvement, such as bacillary angiomatosis, AIDS-related lymphoma, and seborrheic keratosis.[1][2][3]

Differentiating Kaposi's Sarcoma from other Diseases

Diseases Etiology Congenital Acquied Demography Clinical manifestations Lab findings Gold standard diagnosis Additional findings
Symptoms Signs CBC LFT ESR/CRP Histopathology
Appearance Fever Bleeding BP Hepatosplenomegaly Lymphadenopathy Other WBC Hb Plt
Bacillary angiomatosis [4]
  • HIV
  • Chronic lymphocytic leukemia
  • Cytotoxic chemotherapy
  • Organ transplantation
 - + Any age, usually in 20-50 years Solitary or multiple red, purple, flesh-colored, or colorless papules +/- +/- Nl - -
  • Anorexia,
  • Weight loss
  • Abdominal pain
  • Nausea, and vomiting
  • Headache
 Nl Nl Nl Nl Nl Lobular vascular proliferations of vessels lined by plump endothelial cells Clinical manifestation
  • Psychiatric disorders
  • Personality changes
  • Seizure
Arteriovenous malformation [5] Idiopathic
+ - Any age Nl - + Nl - -
  • Headache
  • Neurologic deficits
  • Heart failure
  • Macrocephaly
 Nl Nl Nl Nl Nl N/A Imaging
  • Hereditary hemorrhagic telangiectasia
Acroangiodermatitis [6] Idioathic - - More frequent in male, any ages Purplish-blue to brown papules and plaques - - Nl - - - Nl Nl Nl Nl Nl Hyperkeratosis, parakeratosis, acanthosis, and mild spongiosis Clinical manifesttations
  • Amputees,
  • Haemodialysis (HD) patients with arteriovenous (AV) shunts
  • Paralysed legs
  • Hepatitis C
  • Chronic venous insufficiency
  • AV malformations
Angiosarcoma [7] Idiopathic - - More frequent in males, usually in adults Enlarging bruise, a blue-black nodule, or an unhealed ulceration - - Nl - - - Nl ↓ ↓ Nl Nl
  • Intercellular and intracellular lumina with or without red cells
  • Intermediate filaments and pinocytotic vesiclesin cytoplasm
  • Weibel-Palade bodies
 Biopsy -
Masson's hemangioma [8] Idiopathic - - N/A - - Nl - - - Nl Nl Nl Nl Nl Papillary fronds lined by proliferating endothelium Clinical manifestations and histological findings
  • HemangiomaS
  • Pyogenic granulomas
  • Lymphagiomas
Seborrheic keratosis [9] Clonal expansion of a mutated epidermal keratinocyte + - Any age
  • Usually asymptomatic
  • Being stuck on the skin surface
 - - Nl - - - Nl Nl Nl Nl Nl Papillomatous epithelial proliferation containing horn cysts Clinical manifestations
  • Dermatosis papulosa nigra
  • Stucco keratosis
  • Melanoacanthoma
  • Polypoid lesions
Systemic lupus erythematosus (SLE) [10] Idiopathic - - More coomon in female, typically in the 20 to 30 years
  • Erythema on the nasolabial folds
  • Macular or diffusely erythematous in sun-exposed areas (photosensitive rash)
  • Discoid rash
 +/- - ↑ +/- +/-
  • Weight loss
  • Headache
  • Arthralgia
  • Myalgia
  • Nausea and dyspepsia
  • Pleuritic chest pain
  • Dyspnea
  • Hematuria
 ↑ ↓ ↓ - Nl
  • Hyperkeratosis, epidermal atrophy, vacuolar interface dermatitis
  • Thickening of the basement membrane
  • Superficial, perivascular, and perifollicular mononuclear cell inflammatory infiltrate
 Clinical manifestations
  • Raynaud phenomenon
  • Neuropsychiatric symptoms
  • Pleural effusion
  • Peptic ulcer diseas
  • Pericarditis
  • Myocarditis
Pyogenic granuloma [11]
  • Trauma
  • Hormonal influences
  • Viruses
  • Cytogenetic clonal deletion abnormalities
 + + Any age, usually in 20-30 years Painless red lesion (lobular capillary hemangioma) - + Nl - - - Nl Nl Nl Nl Nl Neutrophilic infiltration, hemorrhage, necrosis of the overlying epidermis Clinical manifestation -
Benign lymphangioendothelioma [12] Idiopathic - + Any ages, median age is 50 years single, slowly expanding patch, plaque, or nodule - - Nl - - - Nl Nl Nl Nl Nl Thin-walled endothelial-lined spaces that are interspersed between strands of collagen Clinical manifestation and biopsy -
Cavernous hemangioma [13] Idiopathic - - Usually in third to fifth decades of life. Painless, slowly progressive protrusion or bulging of their globe - - Nl - - - Nl Nl Nl Nl Nl Engorged vascular channels, which are tightly knit and separated by fibrous septae Clinical manidestation
  • Diplopia
  • Decreased color vision
  • Visual field deficits

References

  1. ↑ 1.0 1.1 Kaposi's Sarcoma. Radiopaedia (2015) http://radiopaedia.org/articles/kaposi-sarcoma Accessed on January, 19 2016
  2. ↑ 2.0 2.1 Libre Pathology. Kaposi's sarcoma (2015) http://librepathology.org/wiki/index.php/File:Kaposi_sarcoma_low_intermed_mag.jpg Accessed on January, 19 2016
  3. ↑ 3.0 3.1 Kaposi's Sarcoma. PathologyOutlines (2015) http://www.pathologyoutlines.com/topic/skintumornonmelanocytickaposisarcoma.html Accessed on January, 19 2015
  4. ↑ Tappero JW, Perkins BA, Wenger JD, Berger TG (July 1995). "Cutaneous manifestations of opportunistic infections in patients infected with human immunodeficiency virus". Clin. Microbiol. Rev. 8 (3): 440–50. PMC 174635. PMID 7553576.
  5. ↑ Whitehead KJ, Smith MC, Li DY (February 2013). "Arteriovenous malformations and other vascular malformation syndromes". Cold Spring Harb Perspect Med. 3 (2): a006635. doi:10.1101/cshperspect.a006635. PMC 3552339. PMID 23125071.
  6. ↑ Lugović L, Pusić J, Situm M, Buljan M, Bulat V, Sebetić K, Soldo-Belić A (2007). "Acroangiodermatitis (pseudo-Kaposi sarcoma): three case reports". Acta Dermatovenerol Croat. 15 (3): 152–7. PMID 17868541.
  7. ↑ Barttelbort SW, Stahl R, Ariyan S (July 1989). "Cutaneous angiosarcoma of the face and scalp". Plast. Reconstr. Surg. 84 (1): 55–9. PMID 2734404.
  8. ↑ Park KK, Won YS, Yang JY, Choi CS, Han KY (July 2012). "Intravascular Papillary Endothelial Hyperplasia (Masson tumor) of the Skull : Case Report and Literature Review". J Korean Neurosurg Soc. 52 (1): 52–4. doi:10.3340/jkns.2012.52.1.52. PMC 3440504. PMID 22993679.
  9. ↑ Noiles K, Vender R (2008). "Are all seborrheic keratoses benign? Review of the typical lesion and its variants". J Cutan Med Surg. 12 (5): 203–10. doi:10.2310/7750.2008.07096. PMID 18845088.
  10. ↑ Uva L, Miguel D, Pinheiro C, Freitas JP, Marques Gomes M, Filipe P (2012). "Cutaneous manifestations of systemic lupus erythematosus". Autoimmune Dis. 2012: 834291. doi:10.1155/2012/834291. PMC 3410306. PMID 22888407.
  11. ↑ Kamal R, Dahiya P, Puri A (January 2012). "Oral pyogenic granuloma: Various concepts of etiopathogenesis". J Oral Maxillofac Pathol. 16 (1): 79–82. doi:10.4103/0973-029X.92978. PMC 3303528. PMID 22434943.
  12. ↑ Guillou L, Fletcher CD (August 2000). "Benign lymphangioendothelioma (acquired progressive lymphangioma): a lesion not to be confused with well-differentiated angiosarcoma and patch stage Kaposi's sarcoma: clinicopathologic analysis of a series". Am. J. Surg. Pathol. 24 (8): 1047–57. PMID 10935645.
  13. ↑ Goldberg RE, Pheasant TR, Shields JA (December 1979). "Cavernous hemangioma of the retina. A four-generation pedigree with neurocutaneous manifestations and an example of bilateral retinal involvement". Arch. Ophthalmol. 97 (12): 2321–4. PMID 229814.

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